Method

Graft Site

Mucosal?

Notes

Intestinal/Sigmoid

Colon tissue

√

Usually laparoscopic. Possible post-operative odor and/or excess of mucus

Peritoneal

Abdominal lining (peritoneum)

√

Usually laparoscopic. Some risk of rectovaginal fistula (an opening which can be sutured in a follow-up procedure). Post-operative dilation is not as critical as it is with other methods, nor is pre-operative hair removal. Provides the largest graft area. Although well-tested in cases of vaginal agenesis, this is the newest method for GAS, and surgeons may be over-eager to try this method, so choose carefully.

McIndoe

Dermal tissue

x

No abdominal surgery. Uses a shaper/mold. Risk of post-operative closure without consistent dilation. Graft site must be free of rough hair.

Buccal mucosa

Oral lining

√

Small graft area

Penile inversion

Penis tissue

x

Graft site must be free of rough hair; preoperative electrolysis is usually indicated. Noted as the providing the most intravaginal and neoclitoral sensation compared with the other methods